Literature about Health Care Reform

The Doctor by Sir Luke Fildes

The Doctor by Sir Luke Fildes

 

At present I am one of those liberals in a high state of anxiety about the prospects of Obama’s attempts to bring us universal health care.   I find myself careening through the highs of hope and the lows of fear.  I watch the political proceedings minutely, then turn away discouraged, then read some columnist expressing hope and return.  Over and over.  Even though I know that the process of making political sausage is always ugly and even though I have quoted in this blog Mario Cuomo’s “we campaign in poetry, we govern in prose,” I still find it emotionally difficult to keep the faith.  I worry, with Washington Post columnist Harold Meyerson, that we have become a “can’t do society”?  I look to literature to see if it can provide me with guidance.

The first work that comes to mind is not encouraging.  I think of Lydgate in one of my favorite novels,  George Eliot’s Middlemarch.  Lydgate is an young, energetic and idealistic doctor who moves to rural Middlemarch with high hopes.  He wants to reform outmoded and ineffective medical practices, he wants to improve the local hospital, and he wants to engage in ground-breaking scientific research.    He has turned his back on his upper-class background to do good in the world.  He thinks he can rise above local politics as he does so.

But local politics prove too much for him.  Other doctors and pharmacists are threatened by him, politicians attempt to use him, and he marries a beautiful but self-centered wife who helps push him into debt.  Then he accepts help from an unscrupulous politician to help him out of his financial difficulties.  In the end he is brought down by his association with this politician and he leaves town.  Although this is what his wife wants, he feels himself a failure and dies at 50.

I don’t think Obama is as naïve as Lydgate—he saw sausage making up close when he was a community activist, legislator, and U.S. senator—but he does share some of Lydgate’s idealism.  In fact, the hope of Obama’s supporters has been that he can balance pragmatism and idealism, that his short stint in legislative politics was enough to introduce him to the process without beating the dreams out of him.  U.S.  politics, like Middlemarch politics, can be death on dreaming, what with its special interest lobbying, pork projects, hugh sums of potentially corrupting cash, and all the rest.  Will Obama, I wonder fearfully, follow the path of Lydgate so that we end up, like Middlemarch, with an unsatisfactory (and in our case financially unsustainable) health care system.


Part of me wants to lash out against our versions of the Middlemarch doctors, pharmacists, politicians, gossip mongers, and all the rest, those who are more interested in seeing our Lydgate fail than in changing health care.   When I think of those who put politics above national interest and who desire only to “break Obama,”  I find myself angrily surfacing an indignant passage from the Oliver Wendell Holmes poem “Old Ironsides”: “The harpies of the shore will pluck the eagle of the sea.”   I sound like a left-wing Ayn Rand. 

But after having had my vent, I then hear a voice that tells me to be a grown-up.  The ways of democracy are always messy and call for us to be strong.   What, did I think that I could thrill to the phrase “the audacity of hope” and not remember why hoping takes so much audacity?  Was I prepared to run screaming from the scene as soon as things got rough?

I go back to look up literary works about hope and of course remember one of the most famous, by Emily Dickinson:

Hope is the thing with feathers 

That perches in the soul, 

And sings the tune—without the words, 

And never stops at all,

And sweetest in the gale is heard;

And sore must be the storm 

That could abash the little bird 

That kept so many warm.

I’ve heard it in the chillest land, 

And on the strangest sea; 

Yet, never, in extremity, 

It asked a crumb of me.

I suspect that many who allowed Obama to persuade them to hope are now panicking over the prospect that this thing with feathers will be crushed, leaving them feeling even more bereft than before.  April can be the cruelest month, not only because of the pain of allowing yourself to believe again after a long season of pessimism, but because (I draw on my experience of living in Minnesota here) you can encounter an a spring blizzard.  Shakespeare tells us to anticipate rough winds that will shake the darling buds of May.

Dickinson reminds us, however, that hope can continue to sing in even the chillest land and during the gale and the storm.  Hope is tougher, in short, than we may be giving it credit for.  So when I am tempted to hover fearfully over my optimism as over a dwindling flame, I need to tell myself that it is at such moments that hope can sing the sweetest.  And that I must persevere.

Here’s a way to make perseverance easier, which I extract from J.R.R. Tolkien’s Lord of the Rings.  Denethor, steward of Gondor, has been assessing the progress of Sauron’s armies of evil by gazing into a palantir, a crystal ball.  But while he sees things that are really going on (the palantir does not lie), Sauron is able to influence the palantir so that Denethor sees only the worst.  In other words, he loses his perspective.  What he misses is his ability of the people around him, and of his allies, to rise to the occasion.  For all of his insight, he cannot foresee the heroic resolve of two hobbits that will save the day.

For me, the discouraging stories within the major newspapers and the Huffington Post that I read on my laptop can function as this palantir (my computer screen seems no less miraculous than Tolkien’s crystal ball), feeding my sense of foreboding.   At such moments I need to turn my gaze elsewhere.

Emily’s poem is a good place to start.  And Middlemarch as well.  The cause of rural English healthcare may have been delayed by the defeat of Lydgate, but characters in the novel emerge from the oh so human mess they have made of their lives to salvage something.  Even if Lydgate’s dreams of reform medicine and Dorothea’s dreams of philanthropy are not fulfilled, they have become deeper and wiser people in their hoping and their striving.  They would not have become wiser and deeper if they had given up at the first signs of adversity.  Remember that, those of you who are dreamers.

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